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Kaiser Permanente COBRA Application For 36Month Qualifying Event Oregon and SW Washington Please complete this application in its entirety and return it to Northwest Carpenters Trusts. You must include
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How to fill out cobra application for 36-month

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How to fill out cobra application for 36-month

01
Obtain the COBRA application form from your employer or insurance provider.
02
Fill out the required personal information, including your full name, address, and contact details.
03
Specify the reason for needing COBRA coverage for 36 months, such as job loss or reduction in work hours.
04
Provide details of your previous health insurance coverage, including the last day of coverage.
05
Submit the completed application form along with any necessary documentation and payment for the premium.

Who needs cobra application for 36-month?

01
Individuals who have experienced a qualifying event that makes them eligible for COBRA coverage, such as a job loss or reduction in work hours, may need to fill out a COBRA application for 36 months.
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The COBRA application for 36 months allows individuals who have lost their health insurance coverage due to certain qualifying events to continue their group health insurance for up to 36 months.
Any employee or their dependents who lose health insurance coverage due to specific qualifying events, such as the employee's termination, reduction in hours, or other life events like divorce or death, are required to file a COBRA application.
To fill out the COBRA application, individuals must obtain the application form from their employer or health insurance provider, complete the required personal and coverage information, and submit it along with any necessary documentation and payment for premiums.
The purpose of the COBRA application for 36 months is to ensure that individuals and their dependents have continued access to healthcare coverage following a qualifying event that would otherwise result in loss of coverage.
The COBRA application must report personal information such as the applicant's name, address, and social security number, details about the health plan, qualifying event type, and the period for which coverage is being requested.
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